Whole Breast Radiation Therapy

 Once a biopsy has been done and breast cancer has been diagnosed, radiation treatment usually involves the following steps:

• Surgery to evaluate underarm lymph nodes to see if the cancer has spread beyond the breast, i.e. sentinel lymph node biopsy or axillary lymph node dissection.
• External radiation therapy to the breast and the surrounding area (involving approximately five weeks of treatment)
• “Boost” radiation therapyto the biopsy site which is usually marked with surgical clips to mark the tumor bed (one additional week of radiation therapy)

For external radiation therapy, a machine beams x-rays to the breast and possibly the underarm lymph nodes. The usual schedule for radiation therapy is 5 days a week for about 5-7 weeks. In some instances, a “boost” or concentrated dose of radiation may be given to the area where the cancer was located. This can be done with an electron beam. Less frequently used is a boost done internally with an implant of radioactive materials.

If you are having radiation therapy as primary treatment for early stage breast cancer, a qualified, board certified radiation therapist who is experienced in this form of treatment should do it.

ADVANTAGES – The breast is not removed. Lumpectomy with radiation therapy as a primary treatment for breast cancer appears to be as effective as mastectomy for treating early stage breast cancer. Because this is a new treatment procedure, researchers are continuing to collect information on long-term results. Usually there is not much deformity of surrounding tissues. The skin usually regains a normal appearance.

DISADVANTAGES – A full course of treatment requires short daily visits to the hospital as an outpatient for approximately 5 weeks. Treatment may produce a skin reaction like sunburn, and may cause tiredness. Itching or peeling of the skin may also occur. Radiation therapy can sometimes cause a temporary decrease in white blood cell count, which may increase the risk of infection. You maintain your breast and, therefore, have a variable risk of local recurrence which would necessitate mastectomy should cancer return. Post-mastectomy reconstruction options are limited after radiation therapy to the breast.

WHAT IS IMRT?

Intensity Modulated Radiation Therapy is a radiation delivery technique. It allows the radiation oncologist to decrease the amount of harmful radiation to normal tissues. The anterior border of the heart and the left lung were particularly vulnerable to radiation exposure. This new technique can spare the normal tissues while adequately treating the breast.

Left sided breast cancers are the ones that will benefit most from this form of radiation therapy.

Ask your radiation oncologist if IMRT would be correct for you.